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Star of the Month: Haley Bodmer
Haley is a 12 year old chocolate Lab who was recently brought into Concord Chapel for a bout of vomiting. As part of her work-up to determine the cause of the vomiting, Dr. Russell ran blood work which was relatively normal. She also ordered abdominal x-rays which did not show a foreign object or any intestinal abnormalities. However, a mass about the size of a softball was seen in Haley's mid-abdomen.
Dr. Russell and Dr. Kerr then used ultrasonography to determine that the mass was coming from Haley's spleen. Splenic masses, like the one Haley had, are difficult to differentiate. There are many different types of tumors that can be found int the spleen but most of the time they are one of three types: hematomas (like a bruise or blood clot in the spleen), hemangiomas (benign tumors of a blood vessel), or hemangiosarcomas (malignant tumors of a blood vessel which can spread to other areas of the body such as the lungs). Without a piece of the mass, there is no way of telling which of the three the mass could be.
Haley had chest x-rays taken which did not show any masses in her lungs or chest. It was then recommended that she have her spleen removed. Dogs, like some other mammals, can live without a spleen, although, this organ does help the body maintain an efficient immune system. It is important to remove splenic masses as they can spontaneously rupture causing severe internal bleeding and, in many cases, death. Haley had surgery to remove her spleen about one week after her chest x-rays were taken. At the time of surgery, lesions that were too small to be seen using ultrasonography were found in her liver. A liver biopsy was taken to determine if the liver lesions were spread from the splenic mass versus another type of lesion. Haley did very well throughout her surgery. Blood work was taken before, just after, and four hours after surgery to make sure she was not bleeding internally from her surgery. All of her blood work was normal. Haley was sent to Diley Hill 24HR Animal Emergency Center overnight and for part of the next day in order to continue monitoring her red blood cell counts, her heart rate, and heart rhythm as some dogs that have their spleen removed experience heart arrhythmias as well as bleeding from the surgery site. Haley had no complications from her surgery. She recovered very well and her vomiting has resolved. Haley, her owners, and the team at Concord Chapel were happy to find out that the lesions in her liver were benign age-related changes and the mass in her spleen was a hematoma which means that Haley's splenectomy was curative allowing Haley to enjoy more life with her owners.
Ruby
First Dr. Lauron examined Ruby and determined that she had a wounded leg and the leg could not be straightened to allow Ruby to walk normally. Then Dr. Lauron drew blood to test Ruby for Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV) which were both negative. After that, Ruby was x-rayed to determine what was wrong with her leg. The x-rays showed pieces of metal with in the tissues of the leg and pieces of bone were actually missing! It appeared that Ruby had been shot. This would be the second animal this year that we have seen at Concord that has been shot in the leg. We also checked her blood work which showed she was anemic (low red blood cell count) and some other abnormalities related to her injury. Ruby was immediately placed on pain medication and antibiotics.
A few days later, Ruby had surgery to remove her leg as it was no longer functional. During that surgery we found that the skin of her leg was trying to heal and was actually attached to her vulva (Ouch!). We removed this attachment in order to remove the leg. Due to the bullet, which must have hit her several weeks prior to her being rescued from the road, her muscles and other tissues inside her leg were scarred and irregular making the surgery a little more challenging. Ruby was also spayed while she was under anesthesia to remove her leg.
Ruby came through surgery with flying colors. She is now doing very well on her healthy remaining legs and gets around wonderfully (as complained about by the team members who try to catch her when it is time to put her back in her cage)! Ruby’s infection and anemia have also resolved and she has been dewormed and vaccinated.
Ruby is soon going to live in a friends barn and try her hand (or paws as the case may be) at mouse catching. In my opinion, those mice better high tail it out of there or they are liable to lose more than a leg!
"K" Robinet and Smokey Gall
Callie Potts (January 2013)
Due to the blood work and urine results, Dr. Lauron also recommended an ultrasound to make sure there were no masses in the liver and to see what the liver tissue looked like without having to surgically go into Callie's abdomen. Ultrasounds, unlike x-rays, actually allow the ultrasonographer to look through an organ rather than "at" and organ. Callie's ultrasound showed engorged vessels and bile ducts as well as a mildly enlarged gall bladder with "sludge" in it.
Based on the ultrasound results, blood work, and urinalysis it was determined that Callie had cholangiohepatitis. This is a really long word that means there is inflammation in the liver and bile ducts which can make the bile ducts look enlarged and can cause there to be "sludge" or thickened bile fluids in the gall bladder. The liver is an organ that filters toxins from the body. The toxins are placed in a liquid called bile which moves through the liver in bile ducts (think of these ducts like water pipes in your house). The bile ducts then empty out into the gall bladder (like your houses septic tank). The gall bladder then empties its contents into the intestines where the toxins and bile eventually leave the body through the feces. When the bile ducts and liver become inflamed, the ducts become "clogged" (like the drain in your sink) and toxins spill over into the blood stream. These toxins then make the animal feel sick.
Callie did very well in the hospital and spent four days with us. She eventually went home, started eating on her own, and acting like her normal self. Callie will be back to see us soon for a medical progress exam and recheck her blood work results. We anticipate that Callie will make a full recovery, however she may need to take Ursodiol for the rest of her life.
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Ruby is a 10 month old female cat that was found by a
Good Samaritan who saw her running, with one leg dangling, across 665 near
Kroger. Ruby was brought into Concord
Chapel the next day to see what we could do for her. Dr. Lauron decided Ruby deserved a second
chance and agreed to take on Ruby’s case.


"K" Robinet is a 3.5 year old female spayed Husky mix that
loves to spend her days running on her family's property with her housemate, Cypress. "K's" owner got a call from a neighbor saying
that they saw "K" lying near the side of the road and she was not moving. "K" was found by her owners 300-400 feet away
from the road. She was alive but could
not walk and was in a lot of pain. When
the Robinet's brought her into Concord Chapel, "K" was pale and had two large
wounds on the inside of her right thigh.
Dr. Russell immediately started "K" on pain medication and ordered blood
work and x-rays to find out what was going on with "K". It was found that "K" had a low red blood
cell count, her heart and lungs were normal, she had no broken bones but she
had bullet fragments inside her right rear leg in the thigh area. Dr. Russell then started "K" on IV fluids and
antibiotics. She also continued her pain
medication.

The next day Dr. Russell took "K" to surgery in order to
remove the bullet fragments. When "K"
was placed under anesthesia and was finally relaxed, Dr. Russell found wounds
in the left rear leg as well. It was
determined that the bullet had passed through the left rear leg and fragmented
in to two larger pieces. These two
pieces then went into the right leg leaving smaller fragments along the wound
track.
After several hours of surgery, Dr. Russell was able to find
several small bullet fragments as well as the two larger fragments and removed
them. She debrided and flushed out the
wounds with antiseptic solution. She
then closed the wounds.
Smokey Gall is a 9 month old female kitten that came to Concord Chapel to be spayed. The owner also told us she had a hernia. When Dr. Kerr examined Smokey, she found that Smokey was completely healthy other than a very large umbilical hernia which was 2 inches around. "A hernia is a protrusion of an organ or fascia of an organ through a body wall that normally contains it (Wikipedia/Hernia)." In Smokey's case the hernia seemed to contain fat which should have been contained in the abdomen but it was difficult to tell by feeling the hernia whether it also extended into the chest cavity. Dr. Kerr recommended x-rays be taken of Smokey's chest and abdomen to try to discover if the heart or chest cavity was involved. The x-rays did not show any abdominal organs in the chest cavity and the size of the heart appeared normal. Dr. Kerr decided to take Smokey to surgery in order to spay her but was a little surprised to find that the hernia, in fact, did extend into the chest cavity. When she pushed the fat back into the abdomen, Dr. Kerr could see the liver, diaphragm, lungs, and the heart. The surgical technician pushed oxygen and anesthetic into Smokey's lungs while Dr. Kerr worked to spay her and to repair her hernia. When a chest cavity is opened to the outside world, pressure from the air outside the lungs makes them collapse so oxygen has to be pushed into the lungs by hand or with a ventilator in order to keep oxygen in the lungs. After Smokey's chest and abdomen were sutured closed, Dr. Kerr had to remove any excess air from around the lungs to decrease the pressure in the air cavity. Dr. Kerr removed a total of 84 mls of air by sucking it out of the chest cavity with a needle and syringe. After the air was removed, Smokey was able to breathe on her own. 

Callie Potts is a 12.5 year old female spayed Calico cat
that came to Concord Chapel Animal Hospital because she was very lethargic and not
eating or drinking for two days. She had
also vomited a couple of times during those two days. When Dr. Lauron examined Callie, she also
noted that Callie was dehydrated. Dr.
Lauron recommended blood work and a urinalysis for Callie. The blood work and
urine showed many abnormalities suggesting Callie may be in liver failure
potentially due to an infection. In dogs
and cats, bacteria can actually travel from the small intestine into the liver
causing infection and inflammation.


Callie was placed on IV fluids to try and "flush" some of
the toxins out of her blood stream as well as to keep her hydrated. Callie was also placed on antibiotics as
bacterial infections of the liver are a common cause of
cholangiohepatitis. She was given
medications to prevent vomiting. She was
also placed on a drug called Ursodiol.
(Keeping with the clogged drain metaphor, Ursodiol is to the liver as
Drano is to your clogged pipes.) This
drug helps remove toxins from the liver, increases the flow of bile, and helps
decrease inflammation in the liver.
This is obviously a very useful drug in the treatment of
cholangiohepatitis.