Category Archives: Case Study

Viral Papillomas or “What is this weird thing on my dog’s lip?”

viral papillomaViral papillomas are small (generally) round skin tumors that some people call warts.  These “viral warts” tend to look a bit like a cauliflower and are most commonly seen in and around the mouth on younger dogs (less than 2 years of age).

The virus is spread through direct contact with papillomas on an infected dog or the virus in the dog’s environment.  The virus can survive up to 2 months in a cold (40F) environment, but only 6 hours in a hot (98F) one.

Papilloma virus tends to infect dogs with an immature immune system, which are usually young dogs and puppies.

In many cases, treatment is unnecessary; the papillomas will go away on their own in one to five months.  Squeezing or squishing the papilloma is thought to stimulate the immune system, but can be uncomfortable to the dog.  But sometimes a dog will have so many papillomas in the mouth that eating becomes difficult.   Papillomas in the mouth can become infected, causing pain, swelling and bad breath.  If the papilloma isn’t going away on its own or is spreading, surgical removal of at least one of them appears to stimulate the dog’s immune system, and all of them will regress afterwards.  A small percentage of dogs respond to azithromycin, an antibiotic.

Four Lakes Veterinary Clinic saw quite a few dogs in the spring of 2015 with viral papillomas.  All of the affected dogs went to doggie daycare.  This fall we are starting to see them appear again.

titus wartIn the spring,  two Shar-Peis from the same family were affected.  Titus, the older dog, was affected first, and had one large papilloma on his mouth.  It grew in size and Titus would sometimes lick or scratch at it, but eventually  it was torn off by the other puppy in the household and regressed on its own.

Two months later, the owners noticed a papilloma in  the younger dog, Nova’s, mouth.   Because Nova developed a lot of papillomas in a short period of time, she was prescribed the antibiotic, azithromycin.  There was no change after two weeks.  We did another round, this time adding in cimetidine, a medication normally prescribed for stomach ulcers, but anecdotally noted to help with papillomas.  Again, there was no improvement and Nova was developing more and larger papillomas in her mouth, on her tongue, on her lips, and near her eye.nova wart mouth

nova wart photo

Because of the owners concern for anesthesia in SharPeis, she was hoping for a non-surgical treatment, but it just wasn’t to be.  Nova was sedated (not at Four Lakes–it was Memorial Day weekend and the owner was visiting her hometown) and many of the papillomas were surgically removed.

Based on advice from other SharPei owners, Nova was fed the papillomas diced up in her food.  Within 10 days, all of Nova’s remaining papillomas were gone and no new ones had cropped up.nova today

I saw other dogs with papillomas that started to become more numerous and not respond to time or azithromycin.  From my experience with Nova, I now recommend surgical removal much sooner than before.  I think it is reasonable to wait several weeks and see if the papilloma goes away on its own, but if there are more forming, I recommend sedation and removal quickly.  I leave it up to owners if they want to feed the papillomas to their dogs, but the growths seem to disappear without that step.

Sissy’s Heartworm Saga

SAMSUNG CAMERA PICTURESSissy is a 2 1/2 year old Blue Tick Hound.  She had been kept outside in a dog house since adopted as a pup.  Since she wasn’t getting the attention she deserved, the original owners gave her up to another family.

Sissy was brought to Four Lakes Veterinary Clinic for an exam and to be spayed.  She was a sweet girl and was getting along very well with her new owner’s other dog.

Sissy’s ovariohysterectomy (spay surgery) went well, with no complications.  She was examined, vaccinated, and blood was sent off to check for heartworms and exposure to tick-borne diseases (like Lyme).

Heartworm-mapHeartworms aren’t terribly common in Wisconsin, especially when compared to warm, southern states.  So we were surprised when her test came back positive.  In addition, a stool sample showed she was infected with 3 other types of intestinal worms: roundworms, hookworms, and whipworms.  Poor Sissy!

She was treated for the intestinal worms with a deworming medication and started on heartworm preventative and an antibiotic prior to starting heartworm treatment in 1-2 months time.  Heartworms are often infected with a bacteria called Wolbachia that can make the body react more strongly to the heartworms.  The antibiotic kills the Wolbachia in the adult worms,  so the lungs have less of an inflammatory response to the heartworms being killed by the Immiticide.

whipworm-adultsInitially Sissy was prescribed Heartgard to start killing the microfilaria (“baby” heartworms), but because that medication doesn’t control whipworms, we decided to give her Sentinel Spectrum instead.  Whipworm eggs, passed in the feces, are very hardy and can stay in the soil a long time, even through harsh winters and hot summers.  Once there are whipworm eggs in the environment, a dog is always at risk of contracting them again.  So giving a monthly preventative that controls them is very worthwhile.

The owner gave the first dose of Sentinel Spectrum and over the next several days Sissy started vomiting and not eating.  It turned out the vomiting was really coughing, so chest x-rays and bloodwork were performed to try and determine what was going on.


Her bloodwork was normal, but we did find microfilaria in her blood.

Thsissylate x-ray showed a lot of inflammation in the lungs, likely heartworm pneumonitis.The most likely scenario was that the high dose of milbemycin in the Sentinel Spectrum killed off a large number of microfilariae quickly. They then got filtered out in the lungs, caused severe inflammation, which then led to the forceful coughing and lethargy.

Sissy was immediately started on steroids, which decreased the inflammation and stopped the coughing, making her feel much better within 24 hours.  Until her heartworm treatment is done and she no longer has microfilaria in her blood, she will take Heartgard monthly.

Sissy took the prednisone, for about 2 weeks.  The amount given was decreased every 4 days.  Near the end of the medication, she developed diarrhea.  We first just treated it like “normal” diarrhea–withholding food for 24 hours then feeding a bland diet.  This didn’t help, so we examined a sample of the diarrhea and were suspicious of a Giardia infection.  She was prescribed metronidazole, which can kill Giardia and is also helpful for other causes of diarrhea.  It didn’t help Sissy at all.  She started defecating fresh blood and not much stool at all.

When I examined her, she had lost weight, her gums were quite pale, and she had fresh blood on the rectal exam.  A complete blood count (CBC) was done and it showed she was anemic and had virtually no platelets, which aid in clotting blood.  Because of all her clinical signs (anemia, low platelets, weight loss, coughing, lethargy, and because she lived outdoors, I started wondering if she might have a fungal infection of Histoplasmosis.  Histoplasmosis isn’t common in Wisconsin, but she did live in other states, where the risk is higher.  The best test for histoplasmosis is through urine, so the owner’s brought in a urine sample the next day.  It took a couple days for the lab to get results, so I also started her back on high doses of steroids, in case her very low platelets were due to destruction by her immune system.

Thankfully, her histoplasmosis test was negative.  Fungal infections can be very difficult to treat.  But the high doses of steroids I started her on were causing her to be extremely ravenous.  She broke out of two very sturdy cages and destroyed the house, eating brillo pads and anything that was in her path.  The owner was ready to relinquish her to the shelter because of the behavior!  It was touch and go for Sissy for that first week.

The high doses of steroids suppressed her immune system, allowing her platelets to rebound.  The blood and diarrhea stopped and she was much more energetic.  As her platelets stayed in the normal range, we started decreasing the steroid dose, which helped with her behavior.  At least she stopped breaking out of kennels!

Now that her platelets are holding steady and in the normal range, she is almost ready for her heartworm treatment!  The plan is to take another chest x-ray to make sure her lungs are all normal, taper the steroid dose a little more, and give the first Immiticide injection.

To be continued…

Piper’s Premolar Problems

Piper is an 11 year old Cocker-Bichon mix belonging to a veterinarian who specializes in chiropractics and acupuncture.  Over Christmas, Piper received a bully stick and enjoyed chewing on it.  One day, however, Piper’s human brothers noticed that she had bad breath.  On closer inspection, her owner noticed a fractured upper fourth premolar (also known as a Carnassial tooth).

Piper was brought to Four Lakes Veterinary Clinic so we could see if the fracture was bad (had an exposed pulp cavity, which could lead to a tooth root abscess) and needed extraction or if it was just loss of enamel.  Sadly, it was definitely a slab fracture–a chunk of the tooth was fractured off and there was exposure of the root canal.  Piper was scheduled to have the tooth extracted.

Once Piper was anesthetized, Allison used a probe to look for other diseased teeth–if the probe goes under the gumline more than about 3 mm, there is bone loss and the tooth may need to be extracted.  The probe found some pockets under the gumline, but none over 2 mm in depth.  Dental x-rays were then taken to assess the health of the roots and look for problems under the gum line.

Since the probing didn’t show any obvious areas of disease, we were a little surprised when we saw the x-rays of Piper’s lower first and second premolars on the left side.

piperbadrootsThe x-ray of the same teeth on the right side showed a little dark area under the first premolar (the small, one root tooth), but since the left side showed lucency around 2 roots, the owner opted for extraction.  All of Piper’s teeth showed some “horizontal” bone loss, which is common in older dogs, especially small breed dogs.  Once there is sufficient bone loss and the bifurcation of the root is exposed, then the tooth needs extracting.

Now poor Piper had 3 teeth that needed to be extracted.  Local lidocaine nerve blocks were given to help with post-op pain.

SAMSUNG CAMERA PICTURESI extracted the lower two premolars first.  The gum over the outside of the tooth is cut and elevated off the bone, then a bur is used to remove some of the bone.  There is a dental tool called an elevator that is inserted alongside the tooth to help break down the ligament holding the tooth in the socket. Once the tooth is loosened, it can be removed.  Then the gum is sutured closed over the holes.

Next I tackled the fractured Carnassial tooth.



First a flap of gum was made over the outside surface, then bone was removed.  The tooth was then sectioned, leaving 2 roots in the front and one in the back, to make elevating and extraction a little easier.


I thought I had extracted all 3 roots, so we took an x-ray to verify.  Much to my consternation, there was a root remaining!


After scrutinizing the x-ray and the extraction site, Allison and I finally found where this root was and extracted it.  I was very glad we took a second x-ray!  I made sure the bone was all smooth, then sutured the gum closed.  Piper recovered nicely!


Why is Daisy Vomiting?

Daisy is a 2 year olSAMSUNG CAMERA PICTURESd cat that was adopted from the local humane society about a month prior to her veterinary visit.  While at the shelter, she was vomiting a few times a week, but everything checked out on her exam.  After she and her sister were adopted, their new owners changed the diet and the vomiting decreased.  But one day she started vomiting frequently–multiple times in one day.  Since the owner hadn’t brought them to a veterinarian yet, he thought this would be a good time to have them checked out.SAMSUNG CAMERA PICTURES

Daisy and her sister, Precious, are beautiful muted  tortoiseshell cats.  Daisy has the most unique whiskers–they have a grey speckled pattern to them, which matches the grey speckled patch on her tail.  But while Precious was exploring the exam room, Daisy sat on the bench and didn’t really want to move around.

During her physical exam, I palpated her stomach and intestines to feel for any pain or lumps.  Her intestines felt normal and she wasn’t showing any signs of pain. Her stomach, however, felt lumpy and irregular-shaped.  We took a couple x-rays and it appeared there was something in her stomach that didn’t look like food.  Her owner mentioned that Precious had found a hair scrunchy and put it in their food bowl, so I wondered what other things Daisy might have found around the house.  Since the object appeared to just be in her stomach, we did discuss sending her to the veterinary specialty hospital for endoscopy.  But if the object hadaisylats moved out of the stomach or isn’t easily “grabbable,” then surgery would be needed anyway.

So Daisy stayed overnight and received IV fluids to keep her well-hydrated, since she wasn’t eating.  The next morning we found she vomited once over night and was just cuddled up in the back of the cage.  I palpated her abdomen daisyjdagain and she was definitely more uncomfortable.  I couldn’t feel her stomach well and wanted to see if the foreign object had moved into her intestines.  An x-ray showed that nothing had moved, which was good.  It is easier to open up just one area, rather than having to make incisions into several areas of the intestines.


SAMSUNG CAMERA PICTURESDaisy was anesthetized and her fur was clipped (just as it was starting to regrow from her spay surgery last month!).





SAMSUNG CAMERA PICTURESAfter prepping her skin and placing a sterile surgical drape over her abdomen, a fairly long incision was made to allow her stomach to be manipulated.  ASAMSUNG CAMERA PICTURESn incision was made into her stomach and I reached in with hemostats and started pulling out the foreign object.



It wasn’t just one object, however!  It turned out to be 12 hair rubber bands along with a rope necklace cord!SAMSUNG CAMERA PICTURES SAMSUNG CAMERA PICTURES




After removing all of that, I sutured the stomach closed, then checked all of her intestines to make sure nothing had moved past the stomach.  Linear foreign objects like rubber bands, yarn, thread, and necklace cord can cause severe problems in the intestines and I didn’t want to miss anything.  But everything was confined to the stomach.  The total surgery time (from making the incision to suturing the skin) was 25 minutes.


Daisy recovered very smoothly and by later in the afternoon she seemed so much happier than that morning!  She liked having her cheeks scratched and seemed hungry.  She went home the same day and she and her sister shared a dinner of canned food.  She has not vomited at all since being home!  Now the hard part–keeping rubber bands and hair products away from her!


Exploratory Surgeries

I’m sure you know the feeling of anticipation and excitement just before you open a present on your birthday.  That is a similar feeling that veterinarians and veterinary technicians feel when they are doing an exploratory surgery on a dog or cat.  Radiographs are analyzed, wagers are made, and eyes crowd the surgery door window in hopes of seeing what the surgeon removes from the gastrointestinal tract.  There is also a feeling of worry and dread (at least by the vet) about what damage that foreign body has wrought on the GI tract.

Recently the staff at Four Lakes had two dogs present within a week with suspected foreign bodies.

SAMSUNG CAMERA PICTURESChief was a 2 year old Labrador Retriever.   He had been vomiting and not feeling well all weekend.  He was dehydrated, so we started him on IV fluids and then took an abdominal x-ray.  We were excited to find:

ChiefrocklatA heart-shaped something!  And lots of gas in his intestines.  No wonder Chief didn’t feel very good!  With the very obvious foreign object, he was taken right into surgery.  Because he had been vomiting and not feeling well for 4-5 days and had a high white blood cell count,  I was very worried about what his intestines would look like, if there was a perforation, and if part of the intestine was going to need to be removed.

Because “exploratory” means just that, the incision made is a long one.  Every organ is examined and the entire length of intestines (estimated to be about five to six times the length of the animal’s body) are “run” through the fingers to feel for any abnormalities. SAMSUNG CAMERA PICTURES In Chief’s case, when I first started to “run the bowels” a firm area was felt.  When that part of the intestine was opened, a wad of black fur and food was found.  I removed it, but that was not the bright white object seen on the x-ray.  I kept going and suddenly found very “angry” intestines–a dark red, inflamed area surrounding a large, hard mass.

I was concerned about the viability of this very inflamed intestinal area.  But removing a portion of intestines and then reattaching the two ends is not a procedure to take lightly.  I removed the hard object (which turned out to be a rock) and then watched the intestines for awhile.  SAMSUNG CAMERA PICTURESThe inflamed area had a good pulse to it and I didn’t see any areas that looked black or that were oozing anything, so I opted to leave them all intact.  Hoping that by removing the obstruction, everything would slowly heal and go back to normal.

 I worried about Chief for days afterwards, but he recovered well.  He started eating soon after surgery, with no further vomiting, and finally passed stool a couple days later.  By the time his skin sutures were removed, he was all back to normal!

The next day a client brought in her new dog, Nelson.  She had adopted him from the Humane Society five days before.  He had been fine, playing with her other dog and then suddenly became lethargic, unable to get comfortable, stopped eating and started vomiting.  On physical exam he was dehydrated and not passing any stool.  We started with x-rays to see if there was a rock in Nelson, too.  His “survey” radiograph showed some odd gas patterns, so we decided to give him some barium dye and see if it passed normally through his intestines.  Barium can help show foreign objects or an obstruction, but it also helps to coat the intestines and can improve gastroenteritis signs.

nelsonbariumlat  Here you can see the barium dye in Nelson’s stomach and the gas in his intestines.

When a barium series is performed, the animal is given the dye orally (sometimes they will eat it up with some canned food) and then x-rays are taken every 30-90 minutes to watch the dye pass out of the stomach and through the intestines.  In Nelson’s case, however, the dye didn’t move at all after 2 hours and then he vomited it up.  His blood work also showed a high white blood cell count, so off to surgery we went.

I was worried about what we were going to find in Nelson, too.  Once anesthetized, he was found to have high blood pressure and an elevated heart rate. I anticipated that whatever it was would be in the stomach, since the dye didn’t pass through, but the stomach was empty.  But I quickly found a dark red, distended area in the intestines. SAMSUNG CAMERA PICTURES I made an incision in the healthy intestines right next to the area and started pulling out this hard, black rubbery substance.  It was a large chunk and I had to cut it in pieces to remove it.  But once it was out, Nelson’s blood pressure and heart rate immediately dropped to normal and the red tissue started looking healthier.  I worried about Nelson after surgery, too, but not as much as with Chief!

The black chunks turned out to be chunks from a hard rubber ball he had been playing and chewing on over the weekend. SAMSUNG CAMERA PICTURES  Luckily he had some insurance coverage from his recent adoption, so part of the surgery was covered.

Both Chief and Nelson recovered well and continue to be healthy, happy dogs.  We much prefer that, but did enjoy talking about their surgeries and the strange things dogs eat for days afterwards!

Sammy and the Scary Pyometra

Intact, unspayed female dogs are at risk for having an unwanted pregnancy as well as developing breast cancer and developing an infection in the uterus.  This infection is called a pyometra (“pyo” meaning pus and “metra” meaning uterus).

female repro tractPyometra is often the result of hormonal changes in the reproductive tract. Following estrus (“heat”) in the dog, progesterone levels remain elevated for eight to ten weeks and thicken the lining of the uterus in preparation for pregnancy. If pregnancy does not occur for several estrus cycles, the lining continues to increase in thickness until cysts form within it. The thickened, cystic lining secretes fluids that create an ideal environment in which bacteria can grow. Additionally, high progesterone levels inhibit the ability of the muscles in the wall of the uterus to contract.  It is generally seen in older female dogs, but potentially could occur at any age.

sammy p

This is what happened in the case of Sammy, an 8 year old black Labrador Retriever.  Sammy was brought in one day because of some discharge from her vulva that she was licking.  The owner thought she might have a urinary tract infection, but the discharge was thick, rather than clear like urine.  Since Sammy hadn’t been spayed, my first concern was a pyometra.


There are two possibilities with a pyometra.  If the cervix is open, then the pus in the uterus will drain out the vulva.  These dogs don’t usually feel too sick and the diagnosis can be more difficult. The other possibility is that the cervix is closed.  When this occurs,  pus and bacteria continue to accumulate and distend the uterus–like having a large abscess inside the abdomen.  Dogs with a closed pyometra are usually very sick–drinking a lot, very lethargic, vomiting, and running a high fever.

Sammy didn’t have a fever and apart from licking a lot at her back end, she was acting pretty normal.  Sometimes x-rays are taken to look for an enlarged uterus or bloodwork done to look for changes that would indicate an infection.  Since I suspected an open pyometra with Sammy, I didn’t think x-rays would be of much use.  But bloodwork was done and found that she had a very high white blood cell count.

There is no good medical treatment for a pyometra, particularly in a non-breeding dog.  Surgery is the very best option as it removes the source of the infection and prevents it from reoccurring.  If a dog has a closed cervix, surgery needs to be done ASAP as there is always the risk of the uterus rupturing and spreading infection into the rest of the abdomen.  Since Sammy’s uterus was draining and she felt fine, she was started on antibiotics and scheduled for surgery the next morning.

SAMSUNG CAMERA PICTURESThis is a picture of Sammy on her back after being anesthetized.  You can see her swollen vulva and the brownish discharge at the bottom.  The fur on her abdomen has already been shaved in preparation for surgery.




A large area of the abdomen is shaved to allow enough room to make a large incision.  The uterus can be quite diseased and tear , so it is important to be able to get into the abdominal cavity easily.



This is the uterus before removal.  It is a Y-shaped organ with two horns (to better hold lots of puppies!).  It is a little thicker than normal because of the infection inside.  But the tissue looks healthy and there is no sign of any leakage into the body cavity.SAMSUNG CAMERA PICTURES



All the blood vessels were tied off and the ovaries and uterus removed together.  Then the body wall and the skin were sutured back together.

SAMSUNG CAMERA PICTURESSammy did very well after the surgery and was back to feeling great within a day.


There are many reasons to get your dog (or cat) spayed early–no unwanted pregnancies, decreased risk of breast cancer, but no risk of pyometra is certainly a very important one!

Cleft Palate

Titus @16 wksTitus is a Chinese Shar-Pei, one of those dogs with all the wrinkles and blue-black tongue.  Here he is at 4 months of age.  Like many Shar-Pei, he has some unique medical concerns due to all those skin folds: eye lids that roll in, small ear canals, small nostrils, and skin problems.  Shar-Peis can also develop “Shar-Pei fever,” where they suddenly spike a fever that can go over 106F, which is very dangerous.

Titus had all of these problems, although his owner did a great job keeping his skin clean, his ears treated, and his eyes lubricated.  As he grew bigger, he started “growing into” his wrinkles, eliminating the need for eye or ear surgery.

One thing Titus always seemed to have was an upper respiratory problems–discharge from his nose, reverse sneezing, and snorting, which then often caused a fever.  He responded well to antibiotics, but his fevers were a concern for all of us.

When Titus was 7 months old, he came in to be neutered.  We finally got a good look at the inside of his mouth as he was intubated:







 We could stick our finger in the cleft.  There was also a small opening on the mid-line of his hard palate.

This cleft opens into the sinus cavity and explained why he got upper respiratory and lung infections.  When the cleft is this far in the back of the mouth, there is a much higher risk of nasal discharge and pneumonia.  This wasn’t a surgery I was prepared to repair, so he was neutered with no complications and the soft palate repair scheduled for a month later.

Titus started getting bigger in that next month and really grew into his wrinkles.  He is such a handsome boy. SAMSUNG CAMERA PICTURESYou can even see his eyes now!

His cleft palate surgery was performed by Elizabeth Laing, DVM, a board-certified mobile surgeon that comes to veterinary clinics to perform more complicated surgeries.




Before the surgery, Dr. Laing assessed his nostrils.  They are narrow, but didn’t seem to be causing him any issues with breathing, so she decided they didn’t need any surgical correction at this time.



SAMSUNG CAMERA PICTURES SAMSUNG CAMERA PICTURESAfter Titus was anesthetized, Dr. Laing positioned him on his back, which gave her the best approach to repairing the cleft.  This is a fairly common problem in bulldogs, so she had built the frame to help hold the mouth open during surgery.  Interestingly, when doing this repair on bulldogs they are usually on their chests, instead of their back.


Here is the view of the cleft, once he was in position.  He had a mouth gag inserted to keep his mouth open and his tongue was taped out of the way.  The syringe on the right side of the picture is just keeping his endotracheal tube properly inflated.



Dr. Laing “freshened” the edges along the cleft and closed the defect in two layers, using absorbable suture material.  She also closed the small defect in the hard palate.

SAMSUNG CAMERA PICTURESAt the end of the surgery, everything was closed up nicely and the end of his soft palate ended before his epiglottis–right where it was supposed to be.

For the next month, Titus is on a strict canned food diet while his palate heals.  No bones, no treats, nothing hard at all.  Hopefully he heals well with no complications and has no further upper respiratory infections!


Femoral fracture

Meet Skillet, a 2 1/2 year old domestic short hair cat.  He is an absolute sweetheart, but
overweight by 5 pounds.  He has a sister, Molly, who is more petite and a grey tabby.  She plays
into this case, too!  At the beginning of October, Molly was brought to Four Lakes Veterinary
Clinic because she was acutely limping on her LEFT rear leg.  She is an indoor-only cat and there
really was no trauma that the owners could remember (except maybe a little nudge with a
foot).  She was very painful in her hip, so she was sedated prior to taking x-rays.
There wasn’t much that could be done to repair this fracture, apart from a femoral head and
neck ostectomy–where the “ball” or head of the femur (which is stuck in the hip socket, or
acetabulum) is removed (in this case, it is already broken off) and the neck of the femur is
removed and then the leg is left to form a “false” joint in the muscles.After 2 months, Molly was doing well on the leg–running and playing with the other cats.  She still had a limp and some muscle atrophy in that leg, but no apparent pain.

But in mid-November, Skillet was brought in because he was suddenly limping on his LEFT hind leg!  We sedated him and took x-rays and saw the EXACT same thing!  There was absolutely no possible trauma to account for his fracture.  Dr. Scarlett wrote up the case on VIN (Veterinary Information Network) and posted the x-rays and got a reply from a veterinarian in Saskatchewan.  He had written a journal article back in 2004 entitled “Atraumatic proximal femoral physeal fractures in cats.”  Apparently this is a spontaneous fracture seen at the growth plate in some young adult cats.  It isn’t known what causes this, although since both Molly and Skillet had this fracture, there is likely some genetic predisposition.  It is most commonly seen in young (~2 yrs or younger), neutered male cats, generally overweight.  The growth plate (physes) tend to remain open much longer in early neutered males, making them more likely to have the “slipped” femoral head.  It is apparently similar to a condition that can occur in obese children (particularly boys) at puberty.

Skillet had his FHO the next day.
SAMSUNG CAMERA PICTURESHere he is, anesthetized and prepped for surgery.





SAMSUNG CAMERA PICTURESThe smooth, shiny head of the femur–the “ball” in the hip joint.





After removing the femoral head from the socket (acetabulum), the sharp neck of the femur is removed and smoothed.  Then the muscle layers are sutured over the bone and the skin is closed.SAMSUNG CAMERA PICTURES






His skin is yellow because of the iodine applied prior to the surgery.  The stitches will stay in about 2 weeks and he should start using that leg fairly quickly.SAMSUNG CAMERA PICTURES






This is the post-op x-ray.  You can see the smooth femur that isn’t touching the hip socket.  It looks just like it is supposed to!skilletpostop

There is about a 33% chance that Skillet and/or Molly will have the same thing happen on the other leg.  We’ll keep our fingers crossed that it won’t!

Here are Molly and Skillet at home.  Molly is laying on her “bad” leg and keeping Skillet company as he recuperates.  What a good sister!20131126_180103

Broken Toe

This is Grizz.  He was apparently a stray cat in Brodhead, WI for the last year or more.  A client,
Conni, has been feeding him and trying to get close to him for the past year.  She had noticed
him limping on a back paw several weeks ago and after 2 “almost got him” attempts, finally got
him trapped in a carrier and brought him in to be neutered and checked out.He spent the night at the clinic and rested comfortably.  He was a little nervous, but happy to be petted once we brought him out of his cage in the morning.  He allowed us to draw some blood.  His feline leukemia and FIV tests were both negative and his complete blood count and chemistries were all essentially normal, too.  By the tartar and staining on his teeth Dr. Scarlett thought he was around 4-5 years of age.  When Dr. Scarlett went to palpate his scrotum to make sure he had two testicles, she was surprised to feel NO testicles!  While cats can be cryptorchid (meaning one testicle is retained in the abdomen and didn’t drop into the scrotum), it would be very unusual to have a cat retain both testicles.  It seemed more likely that he had been neutered in the past.

We scanned him for a microchip and were VERY surprised when we found one!  Sadly, most cats don’t have a microchip.  Natasha called the microchip manufacturer and found out that the microchip had never been registered to an owner.  BUT, they did tell her that the cat had been chipped at Winnebago (Illinois) County shelter.  Natasha called the shelter (which had since changed phone numbers) and found out the cat had been called “Patrick” at the time of adoption.  They gave her the owner’s name and phone number.  The phone number belonged to someone completely different now and a google search for the owner’s name pulled up 6 matches in Wisconsin, none of them in Brodhead.  It appeared Grizz would be Conni’s new cat!  She has since registered his microchip under her name.

Grizz didn’t need to be neutered after all, but he did have an abscess on his left rear paw.  He was sedated and Dr. Scarlett opened, drained, and cleaned the abscess.  The toe moved in an abnormal way, so x-rays were taken:

GrizzAPGrizzoblique The abscess/swelling can be seen on the left side of the paw in the left picture (he got his tail in the x-ray on the bottom) and the toe appears broken at the second joint.  You can see the displacement in the right picture, with the swelling on the bottom.

Grizz received an injectable antibiotic, along with vaccinations and flea treatment.  The paw was bandaged and pain medication was sent home.  Dislocated fractures don’t heal, so once all the swelling has gone down and the infection has cleared up, that toe will be amputated.

Moral of the story: MICROCHIP your pet and REGISTER the number.  We can only assume the original adopter of Grizz no longer wanted him and dumped him–how sad is that?  It would have been far better for Grizz to be taken back to a humane society to find him a loving home.  Grizz is a sweetheart and lucky to have been cared for by Conni!

Tooth root abscess

Meet Cosmo, a 9 yr old Maltese.  He came in the other day because he had a large swelling under his right eye, causing him to squint and have drainage from the eye.  It was very uncomfortable!

Based on the location of the swelling, it was suspected that he had a tooth root abscess.  The upper fourth premolar and the molar both have 3 roots in that area, any of which can become infected and cause an abscess.  He was started on antibiotics and a pain/anti-inflammatory medication and scheduled for a dental procedure.

When he was dropped off for his dental surgery, the swelling had opened up and drained and was less swollen.  Just looking at the teeth, it is hard to determine if they are the problem.

He was anesthetized and dental x-rays were taken, to make sure that the root(s)was the problem.

Full dental x-rays and probing helped determine that 7 of his teeth on the top were diseased–some were loose, some had deep pockets, some had diseased roots on x-ray.  They were all extracted and the gums closed with absorbable suture.

The abscess was flushed with an antimicrobial solution, but left open to drain.  The antibiotics will be continued to clear up the bacterial infection.

After the dental surgery, Cosmo woke up and was happy and excited to get out and run around!