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A 4 month old puppy with a broken heart? Not exactly.... Lizzie, or puppy # 7 when we first met her, was being examined by her veterinarian. She was preparing to be adopted out to her forever home and having her checkup when they detected a heart murmur. At the time Lizzie was just 8 weeks old. A heart murmur is an abnormal heart sound that can be heard when listening with a stethoscope - and this was no ordinary heart murmur... Lizzie had what is often described as a "washing machine" Blood flow through PDAmurmur. This is a loud murmur that is not only heard, but can be felt by hand through the chest.

Lizzie had xrays that showed enlargement of the heart which prompted Lizzie's vet to send her to Allied for an ultrasound of the heart (echocardiogram) to determine if there was a heart defect. The echocardiogram was performed that day and confirmed a birth defect known as Patent Ductus Arteriosus.

Patent Ductus Arteriosus (PDA) is a condition where there is incomplete development of the heart. A single vessel called the ductus arteriosus fails to close as it should at birth - this vessel is necessary in the developing baby because there is no air to breath in the womb. The ductus arteriosus is a blood vessel that ensures the blood (which already has oxygen supplied by mom) does not circulate to the developing lungs. This all changes at birth when the first breath of air is taken. The lungs, now fully developed, will provide the oxygen for the newborn. In the presence of air the ductus arteriosus will close and blood now flows the way it is supposed to - from the right side of the heart to the lungs and then back to the left side of the heart. From there the oxygenated blood can be sent out to the body. Except when the ductus arteriosus doesn't close the way it is should (or remains "patent"). This results in serious, and often life-threatening changes to the normal flow of blood through the heart. In the absence of treatment the majority of animals do not survive a year.

Dr. Moore Performing Surgery on LizzieA diagnosis of a birth defect of the heart is pretty devastating. However, in the case of PDA there are actually treatment options that can be successful in curing the condition. The goal of these treatments is to occlude or close the ductus arteriosus. In humans a technique called coil embolization has been perfected in which a catheter is passed up to the heart and a device, or "coil" is released into the ductus. This coil sticks in the vessel and stimulates a blood clot which will quickly prevent blood from passing through the ductus. The traditional treatment in veterinary medicine is a thoracotomy - in which a surgeon opens the chest, visualizes the ductus and closes by tying a suture around the vessel.

It's safe to say that both procedures are extremely delicate and require a highly skilled and experienced operator to be successful. That being said, pets with PDA that are treated with coil or surgical ligation have a better than 95% of cure and can go on to live a completely normal life!pda3

So back to Lizzie and her broken heart.... after confirming a diagnosis of PDA Lizzie was scheduled for heart surgery. She was in surgery for a little over 60 minutes and the ductus was closed. From there she was taken to ICU for recovery - by that afternoon she was up and barking for food. By the next day Lizzie was on her way home! She's still got some healing to do, but can you imagine undergoing what amounts to open heart surgery and walking out the next day? And best of all, that broken heart is all better!

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How do they do it?  For those of us with pets we often wonder how our fellow non-pet owning neighbors can live in a home that lacks the love and companionship that comes from sharing our lives with our pets.  Of course there are valid reasons that some people cannot have pets - health issues, allergies, and financial considerations are a few.  That said, for the rest of the folks… they just don’t know what are missing.
 
What’s amazing though is that the benefit of pet ownership for some extends beyond
the joy of a knowing the unconditional love of a pet.  Research has shown time and again that pets can provide measurable benefits during times of illness, physical and emotional stress, and chronic disease, and that during these times, animals can provide an improved quality of life.


Some of the reported benefits include reduced anxiety, increased sense of well being both physically and mentally, and increased mental capabilities. In other words, having a pet present can really make a difference in your day to day life.  They are a source of comfort and love, a constant companion, and can provide a true sense of security during difficult times.  Also, attending to the needs of a pet offers some who are often being cared for the ability to be a caregiver themselves.

These benefits are not only recognized by pet owners, in fact the use of animals for therapeutic benefit is an accepted and welcome practice in many hospitals and long term medical care facilities.  A number of different animals are used in therapy, including dogs, cats, elephants, birds, dolphins, rabbits, lizards, and other small animals.  Right here in Tallahassee we are blessed to have an active pet therapy community.  Look no further than our own Tallahassee Memorial Hospital and you'll find the very active Tallahassee Memorial Animal Therapy Teams, a volunteer group that has been sanctioned by the largest pet therapy governing body, the Delta Society.  Visit their websites to learn more about pet therapy, or how you can get involved with these outstanding groups.

Tallahassee Memorial Animal Therapy:
http://www.tmh.org/VolunteerAnimalTherapy

Pet Therapy Inc: http://pet-therapy.org/

The Delta Society: http://www.deltasociety.org/

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Pet owners beware - there is a highly toxic and potentially fatal danger that sits among many people's landscapes all over our region and beyond.   Sago Palm, which isn't actually a palm but a cycad, is a hearty ornamental plant that thrives in both indoor and outdoor settings.  Over the past few years Sago Palms have been gaining in popularity among landscapers across the southeast.  Over that same time veterinarians have begun to see a tremendous rise in incidence of Sago Palm toxicity in pets, with a reported increase of over 200% in some areas of the country.    

 

The poison in these plants is the compound cycasin, and it is found in all parts of the plant including the leaves, roots, and especially the seeds.  Adding to the risk, Sago Palms seem to be highly palatable to pets, especially dogs.  After ingesting the plant pets will become lethargic and have a poor appetite.  The symptoms then progress to vomiting and diarrhea.  In the most severely affected pets this will progress to dehydration, jaundice, liver failure and death.  There is a reported fatality rate of almost 50% in dogs who have ingested the plant.


Seeds of Sago Palm
                                                                                                                                                                                    


Since there is no antidote for cycasin, treatment is aimed at minimizing the effects of the toxin on the body, particularly the liver, brain, and GI tract.  Your veterinarian will likely induce vomiting (if it has been a relatively short time since ingestion) and then administer activated charcoal which can bind to the toxin and prevent absorption in the intestines.  Blood tests will be recommended to evaluate organ function as well as beginning your pet on intravenous fluids.  Additionally, medications need to be given to stabilize, support, and treat the effects of the poison on the body.  Generally these are given by injection to allow the GI tract to rest.  Most pets need to stay at the vet's office for an extended time (several days) while the treatment is being administered.  While many pets do recover, without quick and aggressive intervention the outcome is often not good.

Sago Palms are only one of the toxic ornamental plants that are commonly found in and around homes in Florida.  The toxicity of many of theses is generally mild, however, there are some like Sago that kill many pets each year.  It is recommended that pet owners become knowledgeable about what plants they have in their home and their potential toxicity.  An excellent resource is the ASPCA website (www.aspca.org), or even better - talk with your veterinarian.  They will be familiar with the common toxins in your area and can advise you on what to do to prevent a crisis.

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Ebay flea medication ad

With so many flea and tick products available it can be overwhelming deciding what is right for your pet.  More and more products are available and are no longer sold through vet hospitals only - often they are found on the shelves of retail stores and online pharmacies.  While this offers pet owners options, frequently it does not provide the necessary education in deciding what is right or even safe for their pet. 

There was a time, not that long ago, when flea and tick products were sold exclusively through veterinary hospitals.  In fact, veterinarians have battled for years to prevent the sale of these products through mass retail stores or online discount pharmacies.  Owners can now obtain these products, some with significant potential for harm, with little to no guidance on which product is appropriate and how to correctly use the medications.  While this may appear to benefit the consumer from a cost standpoint, it has also led to a significant increase in adverse events.  The growing safety concerns drew the attention of regulatory agencies groups, who are now taking an interest in these particular products.   An Environmental Protection Agency study determined that "changes need to be made in how we regulate the spot-on products, how companies report data on pet incidents, and how packages are labeled for cats, dogs, and size of animals to prevent unreasonable adverse effects and ensure the safety of these products."  It seems that they are beginning to recognize what veterinary professionals have been concerned about all along - the risk of a pet owners selecting and administering medications without proper direction.

Unfortunately the time to address this particular issue may have come and gone.  The control of these products has gone from veterinarians to the retail market and now appears to be headed the way of many other items in the arena of health care - government regulation.  This well meaning effort will not only ultimately cost consumers money, but it falls short of the mark by failing to return your  family veterinarian, the one who lives in your community and cares about you and your pet, to the position of expert when it comes to what is best for their patients.

 

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Pantyhose, paper, grass, glass, socks, rocks, blocks and just about anything else they can get their teeth on.  If it would fit in their mouth, you can bet there’s a dog that would eat it!  

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SarahCan you tell us a little bit about yourself and how you came to be an emergency vet tech at Allied?

- I’m a college graduate with a degree in Studio Art who desires to become a veterinarian. I’ve been working in animal medicine for the past three to four years starting with a local small animal clinic where I was trained and learned the basics.  After a year or so there I really wanted to expand my knowledge and hands on experience, which led me to apply to Allied.   I thankfully got the job and have grown leaps and bounds in animal medical knowledge and found a true home in the emergency field.

Do you have pets at home?

- I have a cat! His name is Phineas on medical record, but I just call him Cat. He likes that better. I rescued him as a 10 day old kitten - eyes and ears closed - nursed him, and fattened him up into the spoiled, squirrel tailed, wonderful cat he is today. Truth be told I’m more of a dog person, but with the restrictions of a two bedroom apartment and working nights, a cat was just the pet I needed and he is perfect - very dog-like.

Is it hard to stay awake and alert on those long overnight shifts?

- For me no. There is always something to do, whether in patient care, phones to answer, or clients to see. There is rarely a dull moment at the ER and I love to be there for the animals as well as their owners. Staying up of course is a lot easier with coffee on board, but mostly caring for our patients’ needs keeps me on par and moving - making the night generally fly by.

Can you tell us about one of your favorite or most memorable cases as an emergency tech?

- One that always strikes a chord with me is a pitbull that had consumed and overdosed on a client’s muscle relaxers. It came in basically comatose. It was unable to breathe because the drug relaxed the dog’s muscles so much it could no longer expand its diaphragm, however it still had a strong heart beat. The owners told the staff to do whatever we could to help their dog so we breathed for it manually for 24 hours before it could breathe on its own. After 36 hours it was finally able to move its limbs, 48 hours after the initial check in, the patient walked out of the hospital. It truly showed how given the chance, an animals outcome can change dramatically in just 2 days. It’s situations like that which make you proud and help you to remember why you do what you do in animal medicine.

What would you tell others who are interested in a career in emergency veterinary medicine?

- It is truly an unpredictable element. There will be days when nothing walks through the door, and days when the whole city has a problem and it’s up to the doctor and staff to solve it all in a timely manner. You have to be ready to do your best and perform at the highest quality, listen with both ears, anticipate what the doctor will want, and be there for the client no matter what - they are the ones who ultimately decide if a patient gets treated or not. Emergency medicine is where miracles happen right next to a person’s saddest moment. It’s beautiful, exciting, and truly requires heart.

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Emergencies happen, but since our pets can’t explain to us what is going on with them, it is important to know what symptoms require that you get your pet to the emergency hospital immediately.

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Did you know that sugar free gum can be toxic to your pets? Xylitol, the sweetener found in most sugar free chewing gum, has been found to cause a life threatening drop in blood sugar. Even more concerning, at higher doses the sweetener has been shown to cause liver failure and death.

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