Montgomery Vets – 17th April 2014

As it is Good Friday tomorrow, today was my last day at Montgomery Veterinary Clinic. Over the weekend, they are going to be moving to a bigger, purpose-built surgery on the other side of the car park so lots of time today was spent packing up and moving boxes. However, action on the veterinary side of business continued as normal and I began the day in consults. The first was a dog in for a booster. The vet discussed trying a halter for him because the owner mentioned his continual pulling when on the lead. Another point of discussion was the dog’s weight. After being castrated, he had put on weight leading to a body condition score of 5.5 out of 9. With 4.5 being optimum, it wasn’t a serious cause for concern but just something the owner needed to be aware of. The vet suggested reducing meal portions and coming in to be regularly weighed.

The cats I saw being spayed and neutered on Monday were brought in for their post-op check. They were both doing well, but the female would need to come in again next week to have a final check and have her stitches taken out.

One of the most interesting investigations of the week took place when a vet specialising in ultrasound echocardiograms came in to do a heart scan on a Patterdale terrier. The dog had lost almost all her fur after her last season and was coughing badly. They had tried steroids as a treatment for bronchitis but there had been no improvement. The use of steroids could even have worsened the situation as the hair loss could be caused by Cushing’s disease – excessive production of corticosteroids due to a tumour affecting the adrenal or pituitary gland. Cushing’s disease is very hard to diagnose, having to rely on blood tests and clinical signs. However, this scan was not related to Cushing’s but instead the coughing, for they wanted to find out if it was cardiac related. The vet was looking particularly for changes in size and pressure, which may be causing changes in the thorax to result in a cough. Luckily, after trying a couple of different probes and using the ultrasound machine in amazing ways, the vet concluded that there were no significant changes to the heart so the cough was probably a lung problem. Currently, the dog was on medication used for pulmonary fibrosis which was helping slightly. The drug reduces fluid in the lungs and dilates bronchi so the dog was now finding it easier to breathe. This meant that the owner was taking it on longer walks. After discussing several diseases and further investigations which could be done – the owner was keen to reach a true diagnosis – the vets decided to continue with this medication and test for Cushing’s disease. If there was no radical improvement, they could try bronchoscopy and take a sample from the lungs to test. I had a brilliant opportunity to talk to this referral vet after the procedure, so we discussed whether these problems were likely to be caused by one problem or whether there were multiple diseases at play. He showed me his fantastic ultrasound machine and told me about how he travelled the country, offering second opinions to many small veterinary practices.

As well as this, I had a very exciting consult today when 9 French Bulldog puppies were brought in for their first vaccines. They were 8 weeks old and adorable! Every single one of them needed hepatitis, parvovirus, distemper, parainfluenza and leptospirosis as well as health and weight checks. Roland showed me how to draw up the vaccinations into needles so that I could do this whilst he did the checks. There were two bottles, used as a combination to deliver all the vaccines needed. One was a solvent and the other a solution. After drawing up 9 vaccinations, I had got the hang of it and really enjoyed doing some hands-on experience! Whilst I stuck vaccine stickers into the puppies’ brand new record books, I listened to the breeder and vet discussing one puppy in particular with pinched nostrils. This was a common problem with bulldogs and could make breathing difficult. This puppy had already got a new owner lined up, so Roland suggested that the new owner should be told and he would advise an operation when the dog was about one year old to cut open and correct the nostrils. The breeder agreed, and decided to offer to pay for the operation if the new owner wanted to go ahead with it to prevent any disagreements.

A border collie was brought in with a cyst on its ear which had become infected and swollen. The vet drained it and prescribed some antibiotics, giving the owner instructions to keep an eye on it and bring it in if it worsened.

A spaniel was brought in with the owners wanting a second opinion. The dog had been in a fight and had an open, bleeding cut on its ear. They had taken it to their normal vets who had tried to cauterise the cut. But as it had not stopped bleeding, they had sutured it with dissolvable stitches instead. It had now become infected so the owners had come to Montgomery’s, not satisfied with the other vets. After taking off the bandages, the vet looked at it and suggested trying antibiotics and metacam to reduce the infection. He also thought that leaving it open with the dog wearing a buster collar would give it the best conditions for healing. The owners agreed, and they decided that it would be bandaged only if it was a problem left open. The vet then explained that it would need stitches, but only once the infection had gone completely.

A cat was brought in because it was ‘under the weather’. It was normally a lively cat but had suddenly become very quiet and lethargic. There were no other symptoms, with no raised temperature. In cases like these it is very hard for the vet to know what to do, but important for the owner to be aware of the possible risks. The vet decided to prescribe a laxative in case the problem was furballs and instructed the owners to keep an eye on urine and stools, which were normal at present but could be a good indicator of a developing problem. He also suggested that in a week’s time the cat should be treated with milbemax and advocate in case it had worms and because of the mild signs of dermatitis from fleas.

A cat was brought in for a vaccine, but during the routine check-up, the vet noticed it had enlarged thyroid glands. On further examination, he found that the gut was also enlarged and was amazed to find he could grab hold of the intestine from the outside. This was not a good sign as normally the intestine should slide away, being almost impossible to grasp during an external examination. Holding onto the intestine, he was able to accurately take a fine needle biopsy, collecting cells to send off for testing. The vet left it open with the owner as to what it could be, but when the owner left and I asked, he told me that he almost certain this cat had cancer in its gut.

On Tuesday evening, after I had left, a dog had been rushed in after a road traffic accident. On examination, they had found almost no injury but immediately gave anti-inflammatories and painkillers to avoid shock. Today, the dog had come in for a recheck. The vet found a very slight swelling to the paw, but otherwise all was fine and the owners were happy to be discharged.

When I began my week at Montgomery Vets, I was looking forward to seeing lots of exotic animals and my very last consult lived up to expectation. A Royal Python was brought in after having shedding troubles. The owners had moved it to a new, bigger vivarium but this had induced stress, causing the bad shed. As a result, the python had defecated into the shedding skin causing the new skin to become infected. The vet began explaining lots of health care tips to ensure easy sheds, for prevention is the best cure. Now it was important that the remaining old skin was shed successfully, giving the infection a chance to heal. To do this, the snake must be kept between 28-30°C and given a bath twice daily. The vet advised placing the water in the viv to warm up and letting the snake move in to the water when feeling comfortable to do so. It should then be patted dry with paper towel and have iodine solution placed on the damaged area to act as disinfectant. Finally, the owners should try to give an antibiotic injection every third day. The vet explained that if they were not happy to do it themselves, they could bring the snake in but the owners wanted to give it a try. Therefore, Clive gave the first first injection to show us how it was done. The needle had to be slid underneath the skin on one side of the spine. It should then drawn back to make sure there is no blood before slowly compressing the plunger.

I have had a brilliant week at Montgomery Vets and feel I have learnt so much, seeing so many fascinating cases. It has been a joy working alongside such loving and devoted vet and nurses. They have involved in everything so that I have matured, being able to ask questions and set fire to my passion to become a vet. Thank you so much to everyone at Montgomery Veterinary Clinic!

Montgomery Vets – 16th April 2014

Today the first operation of the day was a cat for a mid-line spay. However, as I have seen quite a lot of spays I did not watch this but instead observed a dog having its blood pressure taken and an ultrasound done as part of a kidney investigation. However, there were no obvious indicators so a discussion needed to be had with the owner regarding what to do next.

A basset hound was brought in limping. After an examination, the vet found that touching the muscle was painful whilst the joints were all fine. Limping can take a long time to subside on a basset hound because it is so hard for them to walk on three legs. Therefore, the vet prescribed anti-inflammatories and lots of rest. He suggested that the dog was separated from the Jack Russell terrier it lived with and given at the most 4 very short walks a day. If they maintained this for two weeks before building up exercise again, recovery would be a much quicker process.

A family with two dogs and a cat were brought in for their booster vaccinations, but they also had a host of other issues to discuss with the vet. One of the dogs had bad hind legs with muscle wastage and arthritis. The vet talked to the owner about trying Nutraquin, the product the drug rep had come in about on Monday, as the vet was very keen to see how effective the nutraceuticals could be. The cat had a small which the vet thought was probably from a tick. He explained that the cat’s immune system should deal with the tick’s snout if it was still under the skin whilst the best tick treatment is prevention, for many owners do not realise that advocate does not affect ticks so different treatments are needed.

When a greyhound came in for his booster, Roland did the general check-up, exclaiming about its very loud heart beat. He started telling me about the strong heart of a greyhound and the fantastic electrocardiograms they create. This was what he did his dissertation on, and it was brilliant to listen to his enthusiasm over it. This particular greyhound had a very sensitive stomach so the owners had to be very careful to constantly monitor the food it was eating.

An adorable German Shepherd puppy was brought in for its second booster. The vet discussed some training techniques which would be important to put in place. These could include using a whistle or taking him to puppy training classes. We also looked at the hip and elbow scores the breeder had carried out under the Kennel Club. The elbow score is on a scale of 0 to 3, with 0 being the best and 3 being the most severe, an indicator of elbow dysplasia. This puppy had an elbow score of 0, despite German Shepherds having a higher incidence of elbow dysplasia. The hip score is on a scale of 0 to 106 (53 for each hip), with the lowest scores indicating the least degree of hip dysplasia present. Luckily, this puppy had a relatively low score of 11/12.

A miniature poodle was brought in for a pre-castrate check up but it also suffered with many different problems. This included sciatica, a curved spine and a slipped disk for which it was having hydro and physiotherapy. However, it also had a urine infection, shown by the increased red and white blood cells as well as minerals in the urine. The particular mineral was struvite, the build up of which can lead to urinary tract stones. The vet suggested they should not go ahead with the castrate but prescribed a course of antibiotics then a re-check with the hope of going ahead with it in 10 days time.

Next, a female ferret (jill) on heat was brought in. Roland showed me the swollen vulva and the owner explained she’d seen a small, but luckily not excessive, amount of blood. However, seasons can be very dangerous for a jill if not mated. They can cause fur to fall out along their sides and possible anaemia, even death, if the season is prolonged. Therefore, every three months, this ferret was given a hormone injection to stop the season.

A cat was brought in with TB. When I was told it had TB, I began to worry because of the scare in March when two pet owners caught TB from their infected cats. However, the vet assured me that this was caused Mycobacterium microti. Tuberculosis is most regularly caused by M. tuberculosis, M. bovis, or M. microti. M. tuberculosis causes more than 90% of tuberculosis in humans whilst very rarely causes infection in cats, probably because they are naturally resistant to it. Mycobacterium bovis infects cows, badgers, deer, dogs, cats and humans as well as many other animals. Although all members of the tuberculosis complex pose potential zoonotic risk, it was this zoonose which  was transferred from the cats to their owners. It is as a result of the number of species it affects as to why it has caused so much trouble on farms. However, M.microti is only known to cause infection in voles and cats. The cat brought in was a keen hunter and it was likely it had caught TB from a vole. This cat had lesions on its paws, probably from where the vole had bitten it, transferring the bacteria. But more severely, I was shown an x-ray of its chest and saw the damaged lungs, covered in scar tissue. Treatment involved 6 months of antibiotic medication to ensure all the bacteria were destroyed. However, this particular cat refused to take medication. As a result they had inserted a feeding tube directly into through the neck and into the oesophagus. This meant that the medication could be syringed using a needle into the tube. But, two weeks into treatment, the tube become blocked causing the cat to gag and wretch whilst the owner could not inject the medication. An x-ray was taken, showing that the tube had folded over. Immediately they put the at under anaesthetic and reinserted the tube before taking another x-ray, confirming that the tube was back in place ready for the next six months.

Next, a 14-year old border collie was brought in for a blood test to review medication. It had previously had a lump removed from its liver and although it had very bad arthritis in its back legs, the current liver medication was maintaining the dog in good health. However, now the dog was steady, it was a good opportunity to consider changing the liver medication to a cheaper alternative to be administered less frequently.

A cat was brought in for a booster vaccination. Whilst doing the general check-up, the vet noted the fantastic weight of 4.45kg, reduced from 6.20kg, resulting in a much improved body condition score. He also pointed out the tartar on the cat’s teeth and showed them how it could be picked off with your nail. However, there were also signs of gingivitis which could only be improved if they chose to have the teeth scaled in a dental.

A very cute pygmy hedgehog was brought in with a lump on its tummy. Once the hedgehog was uncurled, we got a moment to have a look and Roland though it was either an abscess which had formed as a result of infection, or a growth. They discussed the option of anaesthetizing and taking a sample for further investigation, but the owners to start with antibiotics and then review progress. This hedgehog was now five years old and kept as a pet, being fed dry cat food and fruit. It is something I have never seen before and I’m not sure whether make particularly good pets, as they are not sociable with humans.

Finally, a dog was brought in with a limp it had suffered with for some time. It was the result of a lump near the nail of the toe. It had not responded to metacam so they decided to try antibiotic in case it was an infection. They could also consider taking a sample or doing an x-ray to explore some further options of the cause.

Montgomery Vets – 15th April 2014

When I arrived this morning, the first patient I saw was a golden Labrador in the kennels for a liver function test. It was suffering with frequent seizures so a variety of investigations were being done. This test involved taking blood then giving the dog some food to eat. Two hours later, more blood could be taken and the two samples would be compared. They were looking specifically for bile acid production. If the liver was functioning normally, the levels of bile acid should be very similar as the liver should have removed excess bile acid, produced as a result of the food, from the bloodstream. It does not specifically matter what food is used, however, fattier foods are ideal.

Also in the kennels was a spaniel for chemotherapy. I was strictly told not to touch the dog, its kennel, or anywhere it had been, for any fluid that comes out of the dog’s body must be treated as contaminated. I hadn’t realised previously, but this meant that the owners were at as much risk as the dog. The strong chemicals used are designed to kill cells and therefore damage the immune system, making both the dog and owners susceptible to many potentially life threatening diseases. At home, it is important that the owners take lots of precautions, handling waste carefully and keeping the dog in the house to prevent others being at risk. The owners had chosen a very expensive drug containing platinum because it was considered one of the safest options. The spaniel was put on an intravenous drip and the drug was injected in using this. Currently, the sessions were given every three weeks with continual monitoring. This involves taking blood samples to check white blood cell count and adjusting the chemotherapy drugs accordingly. I asked about what determined whether radiotherapy or chemotherapy was used and the vet told me that it was entirely dependent on the type of cancer: primarily the position and size of the tumour.

The only procedure under anaesthetic today was a three-year old Yorkshire Terrier having a dental. The vet estimates the number of extractions needed before the procedure begins and then phones the owner to ensure they are happy for it to be carried out. In total, 10 teeth were extracted, most of which were very loose and came out easily due to plaque damage. Roland showed me how he identified the teeth to be extracted according to gum swelling indicating gingivitis as well as cavities and chips in the teeth. He told me that a black line visible on the tooth shows that the inner tooth is decaying. Poor teeth are very common in small breeds such as Yorkshire Terriers as they are often only fed wet food or small pieces of dry food which can be swallowed whole. This means that they do chew enough and their teeth cannot remain clean. This is also often seen in greyhounds because the long shape of their mouths similarly prevents chewing. Whilst the lack of chewing accounts for plaque build up, chips in teeth are often caused by chewing the wrong things such as stones or tennis balls. Teethbrushing is a good option to help maintain good teeth, but Roland expressed an interesting opinion that it the lack of bones for dogs to chew on which has resulted in the increase of poor dental health. He believes that the best option for dogs’ teeth is chewing on large, raw bones.

In the consults today, a sneezing conure was brought in. This was important to treat immediately as birds rarely show symptoms. However, they had already tried antibiotics with no success. Therefore, the vet suggested it was likely to be chemical in the home environment, this could be as random as their new washing machine. He advised giving it a steam bath as inhaling the tiny droplets of water would wash through and clean the mucus, making breathing easier.

A golden retriever was brought in because of facial nerve damage. The muscles on the right side of its face were not working resulting in a lopsided face, most visible when the dog was panting. He also had limited sensation suggesting that some trigeminal nerves were responding. The dog had always had ear problems so this problem was likely to be due to to inflammation of the ear, squashing the nerves. However, it a large area to be affected just by the ear so there could be another underlying cause. Therefore, the vet chose to treat symptomatically, using anti-inflammatories and antibiotics to reduce the ear infection. However, the vet had no way of knowing the situation of the nerves, for if they have been cut through, rather than just squashed/blocked, they cannot be repaired.

A guinea pig was rushed in as an emergency. The owners had noticed it suddenly become very cold and the vet immediately realised it was in shock with an extremely low temperature. It had not been eating for almost three days, despite trying critical care food. We wrapped it in a towel and surrounded it with hot water bottles. Once it had warmed up slightly, it was given injections of a painkiller, gut stimulant and antibiotic. After this, all we could do was leave it tucked up in a warm kennel. Unfortunately, later in the day, the guinea pig went into cardiac arrest and died.

A leopard tortoise was brought in with a lump on its nose. The lump had been bleeding and there had been discharge from the eyes and nose. The vet thought it was either an infection or mass cell tumour. Therefore, he took a cell sample. After showing me how to stain the slides, he had a look under the microscope. I have previously stained at Kingsnorth where I dipped the slides into the stain. But Clive preferred to pipette the stain on as dipping can cause cells to fall off, contaminating other samples. Unfortunately, the samples he looked at were inconclusive so he prescribed anti-inflammatories and antibiotics, treating as if it were an infection. If this did not work they would do further investigations. This was the first time I had seen a tortoise at the vets and as Clive advised the owners on caring for their pet, I picked up some points I hadn’t previously known. Tortoises should be kept at over 20°C for at least 12 hours a day and bathed twice as they do not drink but absorb water through their tail. A ridged shell on a tortoise indicates protein deficiencies whilst tortoise species must not be mixed as some species are carriers of viruses which only affect some species.

Finally, a golden Labrador was brought in due to vomiting. It was a very docile dog so they decided to take an x-ray of her as no sedation would be needed. An x-ray of the abdomen showed gas in the upper small intestine, where it shouldn’t be, but moreover, the stomach was sitting at the wrong angle with the colon too low and the small intestine too high. It was possible that gas could have made the small intestine elevate slightly but the vet thought there was not enough gas to cause this much change. Therefore he thought there was an obstruction in the abdomen which the organs were adhering to. This was bad news as it would most probably be a cancerous lump. The owner understandably became upset so Roland talked to him gently. They decided to do an ultrasound scan to confirm the diagnosis. Miraculously, the ultrasound was entirely normal with no lump visible. It was a joy to see the owner’s relief despite the vet’s confusion. Roland decided to treat symptomatically, monitoring food carefully in an attempt to stop the vomiting. If there was no improvement they could try further investigations, but for now the owner was overjoyed that he would not be carrying the burden of cancer.

Owl

by desmond morris

published by reaktion books ltd in 2009

 

What is this book about?

‘Owl’ by Desmond Morris is part of the Animal Series published by Reaktion Books. It looks at owl anthropology, investigating the relationship humans have had with owls throughout history. It begins by considering prehistoric owls, then moving into ancient, medicinal, symbolic, emblematic, literary and tribal owls. Throughout the text is accompanied by appropriate pictures depicting what is being described whether this be an owl cave painting, an ancient Greek myth or the emblem of a football club.

Morris also considers why the owl has been depicted like this throughout history, exploring how opinions of it have developed and changed. From evil to wise and powerful, many different cultures have influenced the myths and legends surrounding owls.

Finally, Morris explains owls biologically from an evolutionary perspective. He looks at classification, highlighting some extraordinary owls of both the past and present.

Areas of Interest for Further Research

  • Owl Face

One of the first ideas Morris picks up on is the reason humans are fascinated with owls. I have always loved owls, filling my bedroom with pictures and ornaments, though never knowing why. Morris suggests that it is the ‘broad head and the big, forward-facing eyes’ meaning that owls remind us of ourselves. We are genetically programmed to respond to maternal eyes and therefore, the owl triggers a reaction in our bodies giving us a sense of closeness to it. It struck me that this is replicated in other animals, such as kittens, and I would love to look at the chemical reactions behind this.

How good was this book?

I really enjoyed this book because of both the content and the quality of the writing. I found it engaging and felt fascinated by everything Morris picked up on. He has carefully selected interesting snippets of information, giving enough detail but not too much about each one. There is also a brilliant balance of sociological and biological facts, bringing out the true character of the owl depicted by both humans and nature.

Who would I advise this book to?

I would suggest that anyone would enjoy this book. We have all experienced a connection with owls, especially as they become ever more fashionable. The approachable language and structure make it a fantastic and accessible reminder of the history behind our love of owls.