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!

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