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!


Genetic Analysis Testing for your Dog!

Many of us have mixed breed dogs we adopted from an animal shelter or rescue group.  The dog usually comes with some paperwork suggesting a breed that it might be mixed with, but that is just a guess, unless a purebred mother or father are known.  But while it is fun to guess what your mixed breed dog might contain, the accuracy of even educated guesses is pretty low.

There was a research paper published in 2013 where people looked at photos and video clips of 20 different mixed breed dogs (Comparison of Visual and DNA Breed Identification of Dogs and Inter-Observer Reliability, V.L. Voithi, et al)  The results: “For 14 of the dogs, fewer than 50% of the respondents visually identified breeds of dogs that matched DNA identification. For only 7 of the dogs was there agreement among more than 50% of the respondents regarding the most predominant breed of a mixed breed and in 3 of those cases the visual identification did not match the DNA analysis.”  So while about half of the people guessed at least the main breed in the dog, there was vast discrepancy and, at least in a few cases, no one guessed right at all!  (If you want to view the original article, click here.

Another study bred two different purebred breeds together and this is the picture of the puppies–can you guess what breeds they are?Basenji x cockerSome of the guesses at the clinic were: Labrador/beagle, Lab/Springer Spaniel, and beagle/rat terrier.

parents of hybrids

But the parents were actually a Basenji and a Cocker Spaniel!  So you can see how difficult it can be to guess a breed!





Want to try another?  This is Bentley:

SAMSUNG CAMERA PICTURESThe owner was told he was a Chesapeake Bay Retriever mix–he certainly had the size.  His picture was posted on the Four Lakes facebook page and guesses to his parentage included Rottweiler, Golden Retriever, Chow, Labrador, Pitbull, Boxer, Rhodesian Ridgeback, and Chesapeake Bay Retriever.



His DNA test came back as 50% Rottweiler, 25% Collie, and 25% Golden Retriever.

Here’s my dog’s picture (he is getting acupuncture for weakness in his back legs):Chase

When he was younger, an instructor at an obedience class said he was a full blooded American Staffordshire Terrier (ie. Pitbull).  I wasn’t buying that.  I thought he looked more like a short-haired Border Collie (and he loved to chase balls).  Take your guess!

Chase turned out to be a mix of Ibizan Hound, Chow, and Dalmatian, with a little German Shepherd further back in his ancestory.  That explained the thick ruff of fur around his neck and haunches and those spots!  Not sure where the Ibizan hound comes in, however!

But besides being a fun “parlor game” to guess your “cutest dog ever’s” breed, why is important to know what is in your dog’s background?    It can be helpful for understanding your dog’s temperament–is he a breed that tends to be aggressive?  Protective?  A herding breed (might explain why your dog is always chasing the kids!)  Knowing your dog’s genetic makeup can also be very helpful (and potentially save you money) if your dog gets sick.

Crystal Chrisler, a sales representative for Royal Canin, adopted a mixed breed dog and decided to have her DNA tested.

Here are a couple pictures of her (Honey is on the right side in the picture with 2 dogs):


Any guesses to her breed?  The wrinkles on the lower picture are a clue, but would you believe she is 50% Shar Pei?  DSC_0213(The other half was too mixed to distinguish specific breeds).


This is Crystal’s story:   We figured by her appearance that she had some Chinese shar pei in her but I didn’t expect that she was as much as 50%. This past Sunday morning, Honey was acting sick – I couldn’t get her to stand or even open her eyes. Our vet had me take her temperature and after discovering it was 106 we rushed to the Vet ER. Heart rate of 220 – clearly something was up. Normal blood work. The doctor came in to chat with me and asked if I knew her breed, I told him about our GHA results and he had an ‘AH HA!’ moment. Shar Pei fever. Without her breed pointing us to this syndrome, they would have continued diagnostics with radiographs, ultrasounds, EKGs..etc. They treated her with fluids and meds for her fever and she was better by 9pm that same night. She’s doing great now and we have a plan for future fevers.

DNA testing with the Genetic Health Analysis test has been shown to be about 90% accurate.  It only requires a small blood sample from your dog and the cost is quite reasonable–$129.  Take $10 bets from your friends and offer a small prize and you can have the test pay for itself! : )  Give us a call today (608-919-6750) to find out what is in YOUR dog’s mix!


Mated pair — basenji & cocker
BCS F1 hybrids — male and female pair

– See more at:

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!

Bladder stones

SAMSUNG CAMERA PICTURESJasper is a 7 year old, neutered male, orange and white cat that has been urinating bloody urine frequently for a couple months.





He had a urinalysis and x-rays taken and calcium oxalate crystals were found, along with 2 stones in his bladder.  Here is the initial x-ray taken of his bladder.

At the time of his bladder stone diagnosis, he was found to have a heart murmur.  An echocardiogram was performed and Jasper was diagnosed with an elongated mitral valve, causing some outflow obstruction (which makes the blood flow turbulent, leading to the murmur).  He was started on 2 heart medications and cleared for surgery.

His surgery (a cystotomy) went very well.  SAMSUNG CAMERA PICTURESThere was concerned for a very inflamed bladder, due to the expected spikiness of the stones and how long they had been in his bladder, but everything looked very healthy.SAMSUNG CAMERA PICTURES




SAMSUNG CAMERA PICTURESThis is the bladder, exteriorized through the incision.



A small, sterile “spoon” is inserted into the bladder through an incision, and the stones removed.




The bladder is sutured closed and tested to make sure it doesn’t leak.






These were the two, spiky stones found in the bladder.



An x-ray was taken post-op to make sure no stones were missed.  He then had his teeth cleaned and he woke up well.  A few hours after surgery he had already urinated in his litter box!


Hip dysplasia

Jack is a 6 month old Boston Terrier belonging to Natasha, our practice manager/receptionist/tech assistant at the time.  Natasha adopted him at 10 weeks of age and by about 4 months of age noticed that he “runs like a bunny” and that his left hip would “pop out.”  Jack didn’t seem to be in any pain or discomfort from his hip problem and is a very active puppy.
He came in to be neutered and have x-rays taken of his hip to find out what was going on.  Small dogs can develop a condition called Legg-Perthes where the head of the femur (the “ball” in the ball and socket hip joint) basically disintegrates.  Large breed dogs are prone to hip dysplasia, where the head of the femur isn’t held into the acetabulum (socket) very well.

On the day of his neuter surgery, Jack vomited up a cotton-tipped swab and some foam from a stuffed toy, but was otherwise acting fine.  Natasha wanted x-rays of his stomach, in addition to his hips, to make sure he hadn’t eaten anything else of concern.

JacksFBThe neuter went smoothly with no complications.  The abdominal x-rays provided us with a puzzle for the rest of the day until Jack pooped!






Here is the x-ray of his hips:jackships


There were lots of interesting guesses on Facebook as to what that white object might be.  Natasha’s daughter has a Barbie salon and she thought it might be Barbie’s face mask.  A small bedpan was suggested, and it certainly looked like that!  After he woke up from surgery he finally pooped it out.  After a quick wash:

The rubber ear piece from a stethoscope!!

Now, let’s look at the x-ray again:

JacksFBVD w description


So Jack definitely has hip dysplasia and not Legg Perthes disease.  The other hip (which is seen best on the second x-ray above) shows a rather shallow acetabulum.  It is that hip that may end up causing him the most pain.  The hip that is mostly out may not bother him too much, if there isn’t bone rubbing on bone.  But the one that is currently in place may develop arthritic changes over time and be painful.  If surgery is ever needed, a femoral head ostectomy will likely be done to remove the ball and keep it from rubbing on the bone of the hip socket.  But that surgery won’t be considered until Jack is showing signs of pain.

Here is a picture of normal hips (from a Labrador retriever) for comparison–you can see how nicely the head of the femur fits in the actebulum:



Pixel is a Papillon-mixed dog.  He had his first puppy exam when he was 8 weeks old and at
that time only had one testicle descended into his scrotum.  We continued to monitor for both
testicles at each visit, but only the left testicle was present.  The condition where one testicle
fails to descend into the scrotum is call Cryptorchidism.

In the fetus (dogs, cats, humans, etc), a structure called the gubernaculum connects the testicle (located next to the kidney during development) to the scrotum. If this structure fails to develop properly, the testicle will not end up in the scrotum, but will remain in the abdomen or the inguinal canal (which lies next to the prepuce in the dog).  About 4% of mixed breed dogs and 9% of purebred dogs (particularly toy and miniature breeds) will be cryptorchid.  Cats have a lower incidence–about 1% of male cats will be cryptorchid.  It’s considered to be an X-linked, autosomal-recessive trait.

Cryptorchidism can be one-sided (unilateral) or bilateral. In unilateral cryptorchidism the right testicle is retained twice as often as the left. Bilaterally cryptorchid animals are usually sterile because the higher body temperature inside the abdomen is enough to prevent sperm production. (The animals will, however, still exhibit male behaviors.)

If an animal is cryptorchid, he should not be used for breeding. Dogs with cryptorchid testicles are prone to testicular torsion and testicular cancer, so these dogs should be neutered to prevent problems later.  So when Pixel was 8 months old, had all his permanent teeth, and still only the left testicle in his scrotum, he came in to be neutered.


This is Pixel (anesthestized) and on his back; his head is to the left.  Sometimes, if the dog is relaxed and the testicle is at the inguinal ring, you can see or feel it under the skin in the groin area.  It is easy to be fooled into thinking you can feel the retained testicle by fat or a lymph node in that same area.SAMSUNG CAMERA PICTURES

The descended testicle is generally removed first.  An incision is made just above the scrotum and the testicle, spermatic cord, etc is exteriorized, tied off with suture material, and removed.  Then the skin is closed.



The retained tesSAMSUNG CAMERA PICTURESticle was not found in the inguinal canal area, so an abdominal exploratory was done.  This is similar to spaying a female dog–you need to find the retained testicle, which is often around the area of the uterus in a female.  Once the testicle is found, it is tied off and removed like the other one.


It is a little hard to see on this picture, but the retained testicle is always smaller than the one SAMSUNG CAMERA PICTURESthat dropped into the scrotum.







Because I thought I could feel the retained testicle in the inguinal ring, I made an incision there.  No luck, so then I had to make the incision into the abdomen to find it.



This is Pixel recovering after his surgery.


Open House for Independents Week!

IndependentsWeek_Flag Independents weeks is a national campaign celebrating the spirit of community and local businesses.  In conjunction with Dane Buy Local, Four Lakes Veterinary Clinic is excited to participate by holding an open house, along with a dog walk on Wed, July 2.





Stop by anytime on Wed and draw a picture of your pet or favorite animals on the sidewalk.  Pick up a goodie bag and a homemade treat for your cat or dog.  We will have several raffles, vectraincluding one for a Betty Lou Cruise for anyone purchasing at least 3 doses of Vectra 3D.


Starting at 5 pm, we will be giving tours of the SAMSUNG CAMERA PICTUREShospital

and having munchies for humans.  At 6 pm there will be a dog walk in the neighborhood around Four Lakes Vet Clinic.  If you have a Four Lakes t-shirt, please wear it!  After the dog walk we will have the raffle drawings (you don’t need to be present to win).



Our next door neighbors, Harmony Vet Acupuncture & Spine Care will also be giving tours of their facility and root beer floats.  There are other participants in Independents Day, too.  You can find the list here:

Please join us–we’d love to see you!!